Individual
MRS. VIRGINIA W SUMMERALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
338 E COLUMBIA AVE, BATESBURG LEESVILLE, SC 29070-9285
(803) 604-0066
(803) 604-9924
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
123
SC
363LF0000X
Family Nurse Practitioner
APRN 123
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NPO444
—
SC
Enumeration date
02/06/2007
Last updated
11/11/2020
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